Sinonasal teratocarcinosarcoma is an extremely rare malignant tumor arising in the sinonasal tract, having combined histological features of teratoma and carcinosarcoma. Here, we are presenting a case of sinonasal teratocarcinosarcoma in a 28-year-old male patient. A 28-year-old male patient presented with left-sided nasal obstruction and recurrent epistaxis for last 2 months. On examination, a polypoid mass was noted in the left nasal cavity. The mass was surgically resected. Paraffin-embedded sections were made and stained with hematoxylin and eosin. Microscopic examination revealed intimate admixture of carcinomatous (adenocarcinoma), sarcomatous (chondrosarcoma), primitive neuroendocrine and teratoid elements (immature squamous elements). These findings clearly suggest the diagnosis of sinonasal teratocarcinosarcoma. Sinonasal teratocarcinosarcoma is highly malignant and locally aggressive. About 60% of the patients do not survive beyond 3 years. Total excision and extensive sampling are necessary to reach the diagnosis. Early diagnosis and management can give a better prognosis.

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Objective: Meconium passage during labour is a quite common finding. Studies describing correlation between meconium stained liquor, fetal distress and specific placental pathology are sparse. This case control study had been designed to ascertain these lacunae of knowledge. Material and Method: Placentae from 41 cases of otherwise uncomplicated antenatal and intranatal pregnancies with meconium stained liquor at 37 completed weeks of gestation were studied, both grossly and microscopically, comparing them with controls of 41 cases of clear liquor. Apgar score of all newborns at 1 minute and 5 minutes were recorded and correlated with histopathological findings. Results: Both cases and controls were found to be age matched. Meconium stained liquor was associated with more caesarian section than the clear ones. Significant correlation was found with meconium stained liquor and low Apgar scores. Histopathology of placenta revealed many statistically significant associations between specific placental histopathology in meconium stained liquor and depressed Apgar score. Evidence of placental vasculopathy rather than meconium induced placental damage came out as the potential culprit in causing a low Apgar score in this case control study. Conclusion: Placental vascular changes have a role in meconium staining of liquor. If timely interventions are taken, the chance of development of fetal distress is low.

An unusual presentation of leprosy: Lepromatous lymphadenitisLeprosy is a nonfatal, chronic inflammatory disease caused by Mycobacterium leprae, whose clinical manifestations are largely confined to the skin, peripheral nervous system, upper respiratory tract, eyes, and testes.However, here we are reporting a case of leprosy in a 45-year-old male, who presented with bilateral inguinal lymphadenopathy.Left inguinal lymph node was excised surgically and was transported in 10% formalin. Sections were stained with Hematoxylin and Eosin and with modified Ziehl-Neelsen (ZN) technique and were examined under light microscope.Microscopic examination revealed aggregates of foamy histiocytes surrounded by plasma cell infiltrate. Modified ZN stain was performed which showed foamy histiocytes packed with acid-fast lepra bacilli.This report highlights the importance of systemic involvement in leprosy, especially the unusual presentation with lymphadenopathy. Hence, clinicians practicing in endemic areas should bear this fact in mind. Key words: Leprosy, lymphadenopathy, mycobacterium leprae INTRODUCTIONLeprosy is a nonfatal, chronic inflammatory disease caused by Mycobacterium leprae and presents as a spectrum of clinical manifestations from polar tuberculoid to borderline tuberculoid to mid-borderline to borderline lepromatous to polar lepromatous disease, which is associated with an evolution from asymmetric localized macules and plaques to nodular and indurated symmetric generalized skin manifestations, an increasing bacterial load, and loss of leprae-specific cellular immunity. However, in any part of the spectrum the clinical manifestations are largely confined to the skin, peripheral nervous system, upper respiratory tract, eyes, and testes. [1] The prevalence of leprosy in India is reported to be 0.7/10,000 populations. [2] The disease should be suspected when a patient from an endemic area has suggestive skin lesions or peripheral neuropathy. However, this disease can even present with lymphadenopathy only, as can be seen in this particular case. CASE REPORTA 45-year-old male patient was referred to our institute with the complaints of gradually increasing swelling in the inguinal areas of both sides for 6 months duration. The swellings were painless. On clinical examination, the patient was found to have enlargement of inguinal lymph nodes on both sides, the left-sided swelling was 2.0 cm and the right sided one was 1.5 cm in greatest dimension. Excision of the left inguinal lymph node was done surgically and sent to our department for histopathological examination. Fine needle aspiration cytology (FNAC) was not done as it would destroy the lymph nodal architecture.Left inguinal lymph node was excised surgically and was transported in 10% formalin. Grossly, the tissue was globular capsulated mass measuring 2.0 cm × 1.8 cm × 1.5 cm. Cut section was homogenous and grayish white in color. Formalin fixed and paraffin embedded sections were made. Sections were stained with Hematoxylin and Eosin stain and also with modifi...

Congenital cystic adenomatoid malformation (CCAM) occurs secondary to the cystic adenomatous over-growth of terminal bronchioles, which results in the secondary inhibition of alveolar growth. In most of the cases, respiratory distress is the presenting feature during the neonatal period. In about 90% of patients, recurrent respiratory infections necessitating chest imaging reveal CCAM before the age of two years. We describe here the occurrence of congenital cystic adenomatoid malformation of right lung in a 12-year-old girl presenting with haemoptysis and hypovolaemic shock. She underwent right middle lobectomy; and histopathological examination confirmed the diagnosis. She has been doing well on follow-up.